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palmoplantar pustulosis; pustulosis palmaris et plantaris
Etiology:
- chronic plaque psoriasis (10-25%)
- pustular psoriasis
- gluten sensitive enteropathy
- diabetes mellitus type 1
- thyroid disease
- Streptococcal pharyngitis
- SAPHO syndrome (rare)
- TNF-alpha inhibitors
- infliximab, adalimumab, etanercept [1]
Pathology:
- may be a disorder of the eccrine sweat glands (numerous on palms & soles) [1]
Genetics:
- several members of a family may be affected [1]
Clinical manifestations:
- presents as crops of sterile pustules on one or both hands &/or feet
- associated with thickened, scaly, red skin that easily develops painful fissures
- variable in severity
- may persist for years [1]
* images [1]
Laboratory:
- skin biopsy rarely necessary
Management:
- emollient
- topical glucocorticoid
- acitretin
- phototherapy
General
pustular dermatitis
References
- DermNet NZ. Palmoplantar pustulosis (images)
http://www.dermnetnz.org/scaly/palmoplantar-pustulosis.html